CMS Price Transparency Data

Blood test, average blood sugar (A1c)

Facility: Cook Childrens Medical Center Prosper

Billing Code: 83036 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 83036
Insurance Median: $75
Cash Discount Price: $151
vs. Medicare Baseline: 7.72x Medicare

The contracted insurance negotiated median rate for a Blood test, average blood sugar (A1c) at Cook Childrens Medical Center Prosper is $75. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $151. Compared to the federal Medicare reimbursement reference rate of $9.71, this hospital’s rate is 7.72x the Medicare baseline. Located in 4100 W University Drive, Prosper, TX.

Cash / Self-Pay

$151

Average discount available for prompt cash payment at this facility.

Insurance Median

$75

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$9.71

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $9.71 (100%)

Cash / Self-Pay: $151 (1555%)

Insurance Median: $75 (772%)

Cash: $151 (1555% of Medicare)

Ins. Median: $75 (772% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $9.71 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 772% of the Medicare baseline (a markup of 672%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Beacon	$10 - $109	103%
Blue Cross Blue Shield	$10 - $182	103%
El Paso Health First	$10 - $109	103%
Health Plan W. Uhrip	$10	103%
Health Plan W/O Uhrip	$10 - $109	103%
Superior Health	$10	103%
Tx Children Health	$10 - $109	103%
Wellpoint	$10	103%
Aetna	$11 - $172	113%
Firstcare	$11 - $162	113%
United Community	$11 - $75	113%
UnitedHealthcare	$89 - $172	917%
S&W Health	$170	1751%
Cigna	$172	1771%
Healthscope	$172	1771%
Imagine Health	$172	1771%
Humana	$176 - $178	1813%
Multiplan	$176	1813%
First Health	$178	1833%
Galaxy Health	$182	1874%
Healthsmart	$182	1874%
Usamco	$186	1916%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $151.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 83036.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cook Childrens Medical Center Prosper is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 83036.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.